Oakland A’s reliever Sean Doolittle and his fiancee, writer and broadcaster Eireann Dolan, have been involved with veteran’s issues for years. They’ve decided to share what they’ve learned about the challenges facing vets with “bad paper” in this op-ed.

In recent months there has been an ongoing conversation, especially in sports, about what it means to stand during “The Star Spangled Banner”. One argument is that it’s disrespectful to those who served not to stand—it’s about honoring our veterans who fought under that flag, who volunteered to defend our country and fight for our freedoms. If we’re going to have that conversation, then we also need to have a conversation about taking better care of our veterans. If we’re really going to honor them, the national anthem and “God Bless America” shouldn’t be the only times we stand up for them.

Earlier this year, new Secretary of Veterans Affairs (VA) David Shulkin announced the VA would begin providing mental healthcare to “bad paper” veterans—or veterans with “less-than-honorable” discharges—who urgently need it, in an attempt to prevent veteran suicides. Then, on May 3, Shulkin testified before the House Appropriations Committee and promised to expand mental healthcare programs and caregiver support programs, even if the VA isn’t given additional government funding.

At a time when the VA found that 20 veterans die by suicide every day, expanding VA services and mental healthcare to veterans with bad paper is more important than ever. Consider that out of the 20 veterans die by suicide each day, 14 of them were not enrolled in VA care at the time of their deaths.

We both come from military families and are very active supporters of the veteran community. We work very closely with the military charities Operation Finally Home, who build brand new, mortgage-free homes for wounded vets and their families, and Swords to Plowshares, who provide job training, housing support, and legal assistance to former servicemembers. Our efforts with these groups are a big reason why Sean has been nominated for Major League Baseball’s Roberto Clemente Award twice and the Bob Feller Act of Valor Award three times. We’ve learned a lot about the issues our veterans are facing today and when looking for a way to help end the suicide epidemic among veterans, we learned a lot about bad paper, how it affects former servicemembers, and what can be done to help them.

Most vets who’ve received less-than-honorable discharges, known as “bad paper”, are stripped of their legal status as a veteran and may be unable to access VA services like healthcare, disability benefits, education programs or housing assistance, regardless of their service record or deployment history.

There are currently over 500,000 vets with bad paper. According to a FOIA response provided to Swords to Plowshares, over 140,000 of them are post-9/11 veterans, which means we are now discharging servicemembers with bad paper at higher rates than any other era in our history. (To be clear, this does not include the 1% of servicemembers with a dishonorable discharge as the result of a court-martial, only those who find themselves in the ever-expanding gray area between honorable discharge and dishonorable discharge.)

But the alleged misconduct that leads to a bad paper discharge is often the result of behaviors stemming from complications directly linked to combat experience, like Post-Traumatic Stress Disorder (PTSD).

Daniel Ramirez enlisted in the Army at 17 and was deployed to the front lines of the Korean War. After being promoted to Sergeant, he was wounded by an explosion and received the Purple Heart before returning to the front lines. In a desperate attempt to cope with the “shell shock”, Mr. Ramirez self medicated and developed a dependency on alcohol upon returning home from his 11-month deployment. His alcohol dependence soon interfered with his duties, and he was stripped of his rank and separated from the Army with an other than honorable discharge.

Kris Goldsmith was a Sergeant in the US Army who had done a year-long tour of duty to combat zones in Iraq, where his intelligence-gathering duties brought him face to face with the horrors of war. Upon returning from his deployment, Kris suffered from severe depression and undiagnosed PTSD as he struggled to cope with the atrocities he had documented. Kris's contract was about to expire, but he was "stop-lossed", an Army mandate that extended his contract. He couldn't bare the thought of returning to Iraq, and the day before his unit was scheduled to ship out to Baghdad, he attempted suicide. His suicide attempt caused him to miss his flight back to Iraq and he was discharged from the Army with bad paper.

Mr. Ramirez has since been diagnosed with PTSD, and after long procedural battles with the help of attorney representation from Swords to Plowshares, he was finally granted access to VA services—60 years after being separated from the Army. Reversals like this are rare: 3 out of 4 veterans with bad paper discharges who served in combat and who have PTSD are still denied VA eligibility by the Board of Veterans’ Appeals.

Courtesy of James Viray

Goldsmith’s less than honorable discharge left him separated from the Army but still eligible for some VA care. He was officially diagnosed with PTSD three months after his discharge, and he credits the psychiatric care he received from the VA with saving his life.

But even servicemembers who have been diagnosed while still in the military don’t always get the care they need. Between 2009 and 2014 alone, the Army dismissed 22,000 soldiers for misconduct after they returned from Iraq and Afghanistan, even though they had been diagnosed with mental health disorders.

There are also cases in which survivors of military sexual trauma have been given bad paper after they reported being assaulted, only to be discharged with a “personality disorder”—with the incorrect diagnosis of mental illness following them for the rest of their lives.

Bad paper veterans are between 2-3 times more likely to die by suicide, and they are also prevented from having a military funeral or being laid to rest in a military cemetery. They are also at increased risk of unemployment, twice as likely to be homeless, and three times as likely to be find themselves on the wrong end of our criminal justice system.

The bottom line is that VA care can and does work - provided that servicemembers are able to access it. The suicide rate for veterans outside the VA healthcare system has increased at almost 5 times the rate of veterans who use VA services. The conversation must shift to expanding VA care and granting access to the most vulnerable members of the veteran community.

Legislators have been putting pressure on Congress to expand care to help more veterans. Rep. Mike Coffman (R-CO) spearheaded the Fairness for Veterans Act that was passed by Congress last year, requiring discharge review boards to examine veterans for mental health issues before they leave the military. Rep. Beto O’Rourke (D-TX) and Sen. Chris Murphy (D-CT) have continued the momentum with the Honor Our Commitment Act that was introduced in March.

There are still questions that need to be asked, however. Will preventative mental healthcare services be offered? Or will it only be provided in a time of crisis? What about providing healthcare for a physical condition? The good news is that the VA has the power to enact some changes on its own, without waiting for the approval of Congress.

There are already 300 Vet Centers nationwide that provide counseling services for veterans and their families. The VA currently has the power to start working with community healthcare providers to get Vet Center patients access to psychiatric care. Instead of only providing mental health care to bad paper vets in crisis, the VA could start providing primary care—at least on a tentative basis while it determines whether the veteran is eligible for care by the VA.

The fact is that some of the half a million veterans with bad paper may still be eligible for at least some VA services, and restoring their basic “veteran” status would give them access to what the VA considers “basic veteran services” - services like housing, healthcare, and disability programs.

It’s time we honor our commitments. Expanding VA care to veterans with bad paper is one way we can pay respect to the service of all our nation’s veterans. We can’t allow them to be pushed to the margins of society, and we must not let their discharge designation be conflated with the inherent honor and quality of their service.

They provided our nation with a safety net, and we can no longer permit theirs to be pulled out from under them. These men and women represent the best of our country. They signed up to serve when most of us didn’t. Some of them are Purple Heart recipients. Some of them did tours to the most dangerous combat zones on Earth. All of them were aware of the sacrifices they could be asked to make, and they volunteered anyway. As we rise for the national anthem, we must stand up for them. We can’t let them be forgotten, left to fight their toughest battle all by themselves.

Call your Congressional representative—(202) 224-3121—and tell them you support expanding VA healthcare to all veterans by passing the “Honor Our Commitment Act”.